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Brief Psychosocial Intervention to Address Poststroke Depression May Also Benefit Fatigue and Sleep-Wake Disturbance. Rehabil Nurs 2021; 46:222-231. [PMID: 33443981 DOI: 10.1097/rnj.0000000000000304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine if brief psychosocial/behavioral therapy directed to reduce poststroke depression would decrease fatigue and improve sleep-wake disturbance. DESIGN A preplanned secondary data analysis from a completed clinical trial was conducted. METHODS One hundred participants received usual care, in-person intervention, or telephone intervention. Depression, fatigue, and sleep-wake disturbance were measured at entry, 8 weeks, 21 weeks, and 12 months following the intervention. FINDINGS Fatigue (within: p = .042, between: p = .394), sleep disturbance (within: p = .024, between: p = .102), and wake disturbance (within: p = .004, between: p = .508) decreased over the 12 months in the intervention groups, but not in the control group. This difference was clinically meaningful for wake disturbance and approached the clinically important difference for fatigue. CONCLUSIONS/CLINICAL RELEVANCE Reduction in wake disturbance was consistent with clinically meaningful difference standards for patient-reported outcomes, warranting further research in larger samples.
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Fitzsimons CF, Nicholson SL, Morris J, Mead GE, Chastin S, Niven A. Stroke survivors’ perceptions of their sedentary behaviours three months after stroke. Disabil Rehabil 2020; 44:382-394. [DOI: 10.1080/09638288.2020.1768304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Claire F. Fitzsimons
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Sarah L. Nicholson
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Jacqui Morris
- School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | | | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ailsa Niven
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
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Zeldetz V, Natanel D, Boyko M, Zlotnik A, Shiyntum HN, Grinshpun J, Frank D, Kuts R, Brotfain E, Peiser J. A New Method for Inducing a Depression-Like Behavior in Rats. J Vis Exp 2018. [PMID: 29553503 DOI: 10.3791/57137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Contagious depression is a phenomenon that is yet to be fully recognized and this stems from insufficient material on the subject. At the moment, there is no existing format for studying the mechanism of action, prevention, containment, and treatment of contagious depression. The purpose of this study, therefore, was to establish the first animal model of contagious depression. Healthy rats can contract depressive behaviors if exposed to depressed rats. Depression is induced in rats by subjecting them to several manipulations of chronic unpredictable stress (CUS) over 5 weeks, as described in the protocol. A successful sucrose preference test confirmed the development of depression in the rats. The CUS-exposed rats were then caged with naïve rats from the contagion group (1 naïve rat/2 depressed rats in a cage) for an additional 5 weeks. 30 social groups were created from the combination of CUS-exposed rats and naïve rats. This proposed depression-contagion protocol in animals consists mainly of cohabiting CUS-exposed and healthy rats for 5 weeks. To ensure that this method works, a series of tests are carried out - first, the sucrose preference test upon inducing depression to rats, then, the sucrose preference test, alongside the open field and forced-swim tests at the end of the cohabitation period. Throughout the experiment, rats are given tags and are always returned to their cages after each test. A few limitations to this method are the weak differences recorded between the experimental and control groups in the sucrose preference test and the irreversible traumatic outcome of the forced swim test. These may be worth considering for suitability before any future application of the protocol. Nonetheless, following the experiment, naïve rats developed contagion depression after 5 weeks of sharing the same cage with the CUS-exposed rats.
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Affiliation(s)
- Vladimir Zeldetz
- Department of Emergent Medicine, Soroka University Medical Center, Ben-Gurion University of the Negev
| | - Dmitry Natanel
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Matthew Boyko
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev;
| | - Alexander Zlotnik
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Honore N Shiyntum
- Department of Biophysics and Biochemistry, Oles' Honchar Dnipro National University
| | - Julia Grinshpun
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Dmitry Frank
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Ruslan Kuts
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Evgeni Brotfain
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Jochanan Peiser
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
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Bell SM, Maniam R, Patel A, Harkness K, Blackburn D. Patients who are not driving 6 weeks after transient ischaemic attack have higher levels of anxiety. Psychogeriatrics 2017; 17:146. [PMID: 26818414 DOI: 10.1111/psyg.12194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Simon M Bell
- Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Rejina Maniam
- Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Alisha Patel
- Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Kirsty Harkness
- Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK
| | - Daniel Blackburn
- Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK
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Miller C, Peek AL, Power D, Heneghan NR. Psychological consequences of traumatic upper limb peripheral nerve injury: A systematic review. HAND THERAPY 2016. [DOI: 10.1177/1758998316679387] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Introduction Traumatic upper limb peripheral nerve injuries significantly impact individuals’ function and ability to return to work. Patients with peripheral nerve injury experience ongoing psychological impairments for which they are not routinely treated. The aim of this review was to investigate the psychological consequences of traumatic upper limb peripheral nerve injury. Methods A systematic review of MEDLINE, Embase, PsycINFO, CINAHL, AMED, BNI, the Cochrane libraries and grey literature up to October 2015 was undertaken. Two reviewers independently assessed methodological quality in accordance with Cochrane Collaboration recommendations. Eligibility criteria comprised: adults or adolescents with traumatic upper limb peripheral nerve injury using any measurement of psychological well-being. Results Six studies ( n = 245) met the inclusion criteria. Methodological quality varied widely. Evidence of post-traumatic stress disorder at one month, which decreased over time, was reported in three studies. Two studies found a statistically significant correlation between the early presence of post-traumatic stress disorder and reduction in function at 12 or more months. Limited information was available on anxiety, depression and mental quality of life. Combined nerve injuries (in two studies) had significantly higher levels of post-traumatic stress disorder, at one month, compared to those with an isolated nerve injury. Conclusion There is some evidence of early post-traumatic stress disorder following traumatic upper limb peripheral nerve injury, which may have an impact on functional outcome. However, high-quality studies using prospective cohorts are required to further evaluate the psychological aspects associated with this traumatic injury.
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Affiliation(s)
- Caroline Miller
- Birmingham Hand Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Dominic Power
- Birmingham Hand Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Boyko M, Kutz R, Grinshpun J, Zvenigorodsky V, Gruenbaum SE, Gruenbaum BF, Brotfain E, Shapira Y, Zlotnik A. Establishment of an animal model of depression contagion. Behav Brain Res 2014; 281:358-63. [PMID: 25523029 DOI: 10.1016/j.bbr.2014.12.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/03/2014] [Accepted: 12/07/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Depression is a common and important cause of morbidity, and results in a significant economic burden. Recent human studies have demonstrated that that depression is contagious, and depression in family and friends might cumulatively increase the likelihood that a person will exhibit depressive behaviors. The mechanisms underlying contagion depression are poorly understood, and there are currently no animal models for this condition. METHODS Rats were divided into 3 groups: depression group, contagion group, and control group. After induction of depression by 5 weeks of chronic unpredictable stress, rats from the contagion group were housed with the depressed rats (1 naïve rat with 2 depressed rats) for 5 weeks. Rats were then subjected to sucrose preference, open field, and forced swim tests. RESULTS The sucrose preference was significantly reduced in the depressed rats (p<0.01) and contagion depression rats (p<0.01). Climbing time during forced swim test was reduced in the depression and contagion depression groups (p<0.001), whereas immobility time was significantly prolonged in only the depression group (p<0.001). Rats in both the depression (p<0.05) and depression contagion group (p<0.005) had decreased total travel distance and decreased mean velocity in the open field test, whereas the time spent in the central part was significantly shorter in only the depression group (p<0.001). CONCLUSIONS In this study, for the first time we demonstrated depression contagion in an animal model. A reliable animal model may help better understand the underlying mechanisms of contagion depression, and may allow for future investigations of the studying therapeutic modalities.
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Affiliation(s)
- Matthew Boyko
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
| | - Ruslan Kutz
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Julia Grinshpun
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Vladislav Zvenigorodsky
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Shaun E Gruenbaum
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA
| | - Benjamin F Gruenbaum
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA
| | - Evgeni Brotfain
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Yoram Shapira
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Alexander Zlotnik
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
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Moran GM, Fletcher B, Feltham MG, Calvert M, Sackley C, Marshall T. Fatigue, psychological and cognitive impairment following transient ischaemic attack and minor stroke: a systematic review. Eur J Neurol 2014; 21:1258-67. [PMID: 24861479 DOI: 10.1111/ene.12469] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/07/2014] [Indexed: 11/28/2022]
Abstract
Transient ischaemic attack (TIA) and minor stroke are characterized by short-lasting symptoms; however, anecdotal and empirical evidence suggests that these patients experience ongoing cognitive/psychological impairment for which they are not routinely treated. The aims were (i) to investigate the prevalence and time course of fatigue, anxiety, depression, post-traumatic stress disorder(PTSD) and cognitive impairment following TIA/minor stroke; (ii) to explore the impact on quality of life (QoL), change in emotions and return to work; and (iii) to identify where further research is required and potentially inform an intervention study. A systematic review of MEDLINE, EMBASE, PSYCINFO, CINAHL, the Cochrane libraries and the grey literature between January 1993 and April 2013 was undertaken. Literature was screened and data were extracted by two independent reviewers. Studies were included of adult TIA/minor stroke participants with any of the outcomes of interest: fatigue, anxiety, depression, PTSD, cognitive impairment, QoL, change in emotions and return to work. Random-effects meta-analysis pooled outcomes by measurement tool. Searches identified 5976 records, 289 were assessed for eligibility and 31 studies were included. Results suggest high levels of cognitive impairment and depression post-TIA/minor stroke which decreased over time. However, frequencies varied between studies. Limited information was available on anxiety, PTSD and fatigue. Meta-analysis revealed that the measurement tool administered influenced the prevalence of cognitive impairment: Mini-Mental State Examination 17% [95% confidence interval (CI) 7, 26]; neuropsychological test battery 39% (95% CI 28, 50); Montreal Cognitive Assessment 54% (95% CI 43, 66). There is evidence to suggest that TIA/minor stroke patients may experience residual impairments; however, results should be interpreted with caution because of the few high quality studies. Notwithstanding, it is important to raise awareness of potential subtle but meaningful residual impairments.
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Affiliation(s)
- G M Moran
- Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
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Sivakumar L, Kate M, Jeerakathil T, Camicioli R, Buck B, Butcher K. Serial montreal cognitive assessments demonstrate reversible cognitive impairment in patients with acute transient ischemic attack and minor stroke. Stroke 2014; 45:1709-15. [PMID: 24757105 DOI: 10.1161/strokeaha.114.004726] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive changes after ischemic stroke are often overlooked, particularly acutely and in patients with mild or transient deficits. We assessed patients with transient ischemic attack (TIA)/minor stroke with serial cognitive screening tests. We tested the hypothesis that mild acute deficits are transient and improve after TIA/minor stroke. METHODS Patients with acute TIA/minor ischemic stroke, without a history of cognitive impairment, presenting with a National Institute of Health Stroke Scale score ≤3 were assessed <72 hours of onset. Patients were administered the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) at days 1, 7, 30, and 90. Cognitive impairment was defined as MoCA <26 and MMSE ≤26. RESULTS One hundred patients with a median (interquartile range) National Institute of Health Stroke Scale score of 1 (2) and median age of 68 (20) years were included. Baseline median MoCA score (26 [4]) was lower than the MMSE (29 [2]; P<0.0001). Cognitive impairment was detected in 54 of 100 patients (54%) with MoCA and 16 of 100 (16%; P=0.001) with MMSE. MoCA scores improved at day 7 (27 [5]), day 30 (28 [2]), and day 90 (28 [2]; P<0.0001). Resolution of cognitive deficits was because of resolution of recall deficits. CONCLUSIONS Acute temporary cognitive impairment after TIA/minor stroke is common. The MoCA is sensitive to these changes, but the MMSE is not. Routine cognitive assessment after TIA/minor stroke may be warranted and relevant to return to activities even when other neurological deficits are not evident.
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Affiliation(s)
- Leka Sivakumar
- From the Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Mahesh Kate
- From the Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Thomas Jeerakathil
- From the Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Camicioli
- From the Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Brian Buck
- From the Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Ken Butcher
- From the Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada.
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